scholarly journals Inguinal hernia repair – TEP or TAPP?? A comparative analysis between both the laparoscopic procedures in a tertiary care center

2020 ◽  
Vol 11 (6) ◽  
pp. 84-88
Author(s):  
Atia Zaka Ur Rab ◽  
Sheikh Saif Alim ◽  
Wasif Mohammad Ali ◽  
Syed Amjad Ali Rizvi
Keyword(s):  
Inguinal Hernia ◽  
Hernia Repair ◽  
Prospective Study ◽  
Hospital Stay ◽  
Inguinal Hernia Repair ◽  
Tertiary Care ◽  
Number Of Patients ◽  
Significant Difference ◽  
Duration Of Surgery ◽  
Normal Work

Background: Inguinal hernia surgery is one of the most common elective procedures performed by the surgeons and has evolved from open to the laparoscopic technique. Aims and Objectives: This prospective study was conducted to find out intra-operative and post-operative outcomes in patients undergoing TEP and TAPP for inguinal hernia repair. Materials and Methods: A prospective study was conducted on 50 adult patients who underwent laparoscopic inguinal hernia repair between November 2017 to November 2018. It was a randomized study and equal number of patients were allocated to TAPP and TEP group based on the surgeon’s preference. Results: Operative time [p<0.0001], intensity of pain (VAS) was significantly higher in TAPP compared to TEP in the immediate post-operative period (6 hours) and during hospital stay [p=0.0299]. No significant difference observed in VAS between TEP and TAPP during follow up [after 1 week (p=0.2298), 2 weeks (p=0.2337), and 4 weeks (p=0.3944)]. Both TEP and TAPP were comparable in terms of Intra-operative and Post-operative complications {seroma [during hospital stay (p=0.1573), after 1 week (p=0.6375), after 2 weeks (p=0.5513)]; haematoma [during hospital stay (p=0.1492), after 1 week (p=0.3125)]} and Conversion (p=0.3125), and Length of hospital stay (p=0.3960). Time to resume normal work [p<0.0001] was significantly more in TAPP than TEP. Conclusion: TEP has a definite edge over TAPP taking into consideration the lesser intensity of post-operative pain during hospital stay, shorter duration of surgery and relatively early return to normal work associated with the former procedure. TEP should therefore be regarded as the procedure of choice for inguinal hernia repair.

scholarly journals Prospective Randomized Blinded Study to Compare Laparoscopic and Open Inguinal Hernioplasty

2020 ◽  
Vol 3 (1) ◽  
pp. 149-154
Author(s):  
Mohd. Ilyas ◽  
Venkat Vaijnath Cholleti
Keyword(s):  
Inguinal Hernia ◽  
Hernia Repair ◽  
Hospital Stay ◽  
Inguinal Hernia Repair ◽  
Randomized Study ◽  
Early Assessment ◽  
Post Operative Pain ◽  
Number Of Patients ◽  
Study Results ◽  
Significant Difference

Background: Hernia is one of the common surgical problems. Repair of inguinal hernia is one of the commonest surgical procedures worldwide, irrespective of country, race or socio-economic status and constitutes a major health-care in every country. Subjects and Methods: This is a randomised prospective study done over 50 patients in the department of general surgery of Kamineni hospitals, LB Nagar, Hyderabad during the period of October 2010 to August 2012 with the aim to compare laproscopic inguinal hernia repair and open inguinal hernia repair with regards to post-operative pain, surgical site infections, hospital stay and time taken to return to work, by a randomized study. Results: Compare laparoscopic and mesh inguinal hernia repairs, there is no significant difference in early assessment with regards to duration of operation, post-operative pain, analgesic requirements on the day of surgery and first post-operative day, hospital stay, return to daily and normal activities and post-operative complications. Conclusion: Laparoscopic mesh hernioplasty still remains to be validated with larger number of patients and longer duration of follow up.

scholarly journals Desarda’s versus Lichtenstein technique of inguinal hernia repair

2017 ◽  
Vol 5 (1) ◽  
pp. 92
Author(s):  
Obaid Syed
Keyword(s):  
Inguinal Hernia ◽  
Hernia Repair ◽  
Hospital Stay ◽  
Complication Rate ◽  
Mesh Repair ◽  
Post Operative Pain ◽  
Significant Difference ◽  
Duration Of Surgery ◽  
Operative Complications ◽  
The Mean

Background: Ideal method for modern hernia surgery should be simple, cost effective, safe, tension free and permanent. The Lichtenstein operation to a great extent achieves this entire goal. The Lichtenstein mesh repair is associated with complications, postoperative dysfunction and high cost composite meshes. Desarda's technique, became a new surgical option for tissue-based inguinal hernia repair. The present study was designed to evaluate and compare the effectiveness and complications of the Desarda’s repair with Lichtenstein tension-free mesh repair for treatment of inguinal hernia in a developing country.Methods: 200 patients with unilateral, primary, reducible inguinal hernia were selected. Included patients were randomly divided into two groups. Studied parameters were Duration of surgery, intra operative complications, post-operative Pain, Duration of hospital stay, return to normal activities, post-operative complications and recurrences.Results: There were a total of 100 patients each group. There was no statistically significant difference in duration of surgery and complication rate between the two groups. Difference in mean VAS was not statistically significant. The mean hospital stay in Desarda’s technique was 2.5 days while it was 2.6 days in Lichtenstein’s group. The mean time to return to basic physical activity in the Desarda’s technique was 12.6 days while it was 13.3 days in the Lichtenstein’s group. There were no recurrences in either group. Chronic inguinal pain (>1month) was more frequent in Lichtenstein’s group.Conclusions: There is no significant difference in duration of surgery, intra operative complication rate, post-operative pain, complications and recurrence, between Desarda’s technique and Lichtenstein’s technique. However chronic inguinal pain is less in Desarda’s technique. Desarda’s repair must be considered in young patients (<30 years). Its long-term efficacy needs to be studied with larger, prospective double-blind randomized trials, with longer follow-up.

scholarly journals Factors that predict testicular atrophy in patients who underwent inguinal hernia repair

2020 ◽  
Vol 7 (11) ◽  
pp. 3550
Author(s):  
Faraj Afandiyev ◽  
Haydar Celasin ◽  
Serdar Culcu
Keyword(s):  
Diabetes Mellitus ◽  
Inguinal Hernia ◽  
Hernia Repair ◽  
Inguinal Hernia Repair ◽  
Open Repair ◽  
Testicular Atrophy ◽  
Predicting Factors ◽  
Number Of Patients ◽  
Duration Of Surgery ◽  
Rheumatological Disease

Background: Some of the patients that undergo inguinal hernia repair develop testicular atrophy. Testicular atrophy development also brings about a lot of problems. In our study, we aimed to determine the rate of development of testicular atrophy and predicting factors in patients that undergo inguinal hernia repair in our hospital.Methods: Patients who underwent inguinal hernia repair in our centre from January 2017 to January 2020 were included in our study. Total number of patients was 158 divided into 2 groups i.e. group-1 (those who developed testicular atrophy after inguinal hernia repair) and group-2 (those who did not develop testicular atrophy after inguinal hernia repair). We investigated the relationship between the development of testicular atrophy and age, hernia type and localization, duration of surgery and anesthesia, perioperative non-steroidal anti-inflammatory drugs (NSAID) and antispasmolytic use, diabetes mellitus and rheumatological disease and, perioperative fluid replacement.Results: Testicular atrophy developed in 6 of the patients (3.79%). We found that testicular atrophy was mostly secondary and mostly visible in cases underwent open repair (p=0.0001); and in which left and bilateral inguinal hernia repair was performed (p=0.014); and in cases with DM and rheumatological diseases (p=0.0001). We also found that the use of perioperative antispasmolytic and NSAID was lower in patients with testicular atrophy (p=0.0001).Conclusions: According to the results of our study, advanced age, secondary and open repair, diabetes mellitus, rheumatological disease history, not using antispasmolytic and NSAID increases the risk of testicular atrophy.

scholarly journals Study of testicular perfusion after Lichtenstein hernioplasty in uncomplicated inguinal hernia

2018 ◽  
Vol 5 (3) ◽  
pp. 1104
Author(s):  
Prabhu Nath ◽  
Subhajeet Dey ◽  
Tanweer Karim ◽  
Atul Jain ◽  
Vivek Kumar Katiyar ◽  
...  
Keyword(s):  
Inguinal Hernia ◽  
Hernia Repair ◽  
Inguinal Hernia Repair ◽  
Tertiary Care ◽  
Test Analysis ◽  
Lichtenstein Hernioplasty ◽  
Significant Difference ◽  
Testicular Ischemia ◽  
Testicular Perfusion ◽  
One Year

Background: Inguinal hernia repair is one of the most commonly performed surgical procedures in the world. The aim is to achieve a recurrence free hernia repair with minimum of complications. In mesh inguinal hernia repair testicular cord structures are in direct contact with the mesh. Testicular ischemia usually manifests within 48-72 hours after surgery. Aims of the study was to asses any changes in perfusion of ipsilateral testis after Lichtenstein hernioplasty and establish a baseline testicular perfusion pattern in the study population. This study was conducted in the Department of Surgery for one year at a tertiary care teaching hospital in Delhi.Methods: All consenting adult male patients undergoing Lichtenstein inguinal hernioplasty for unilateral inguinal hernia fulfilling the inclusion and exclusion criteria. A sample size of 50 was included in study.Results: In this study patients were above 18 and below 60 years of age with mean age of 43.58 years.  The paired T-test analysis revealed no statistically significant difference between pre and post-operative values of SV, DV, RI, PI and TV.Conclusions: Lichtenstein tension free mesh repair for uncomplicated inguinal hernia does not impair testicular perfusion after the procedure.

scholarly journals Managing bilateral inguinal hernia laparoscopically: is it gold standard?

2016 ◽  
Vol 4 (1) ◽  
pp. 296
Author(s):  
Kalpesh H. Patel ◽  
Jayesh B. Gohel ◽  
Bhumika J. Patel
Keyword(s):  
Inguinal Hernia ◽  
Hernia Repair ◽  
Hospital Stay ◽  
Inguinal Hernia Repair ◽  
Length Of Hospital Stay ◽  
Control Group ◽  
Bilateral Inguinal Hernia ◽  
Group I ◽  
Significant Difference ◽  
Group Ii

Background:Even after many studies done in recent years, no consensus has been achieved on the surgical technique of inguinal hernia repair. It was believed that in bilateral inguinal hernia cases laparoscopic surgery is very much advantageous as it can be done through same incisions as unilateral laparoscopic inguinal hernia repair (no additional incision required), whereas in open surgery for bilateral case separate groin incision for each side required. Aim of this study is to evaluate and compare results of bilateral inguinal hernia patients operated by laparoscopic (transabdominal preperitoneal) or open (lichenstein) repair.Methods: A prospective comparative study was conducted in a tertiary care teaching hospital over the period of two years. 60 patients with bilateral inguinal hernia were taken up and randomly divided into two groups. Group I (study group) includes patients operated by bilateral laparoscopic hernia repair (TAPP) and Group II (control group) includes patients operated by open hernia repair (lichenstein tension free hernioplasty). All patients were followed up for 18 months post-operatively. All patients of both groups were monitored for operative time, conversion rate, length hospital stay, post-operative complications and recurrence, time to return to work.Results:Statistically there was significant difference between both groups in terms of length of hospital stay and time to return to work. Group I patients where TAPP surgery performed, 22 patients (73.33%) were discharged within 36 hours of surgery, whereas in Group II patients - control group where open surgery performed, only 4 patients (13.33%) discharged within 36 hours. All 30 patients (100%) in group I had joined their routine work within 10 days of surgery; whereas in Group II patients only 4 cases (13.33%) joined duties on or before 10 days and most of the patients 26 (86.67%) had taken more than 10 days to resume their duties. But there was no significant difference between operative time, complication rates and recurrence rates. All cases in group I were completed laparoscopically (no conversion to open repair).Conclusions:Simultaneous bilateral inguinal hernia repair laparoscopically does not increase the risk for the patient and has an equal morbidity compared with unilateral repair, length of hospital stay, and return to normal work and over all recovery after laparoscopic repair is faster than after open bilateral simultaneous repair. Laparoscopic inguinal hernia repair of bilateral hernias should be recommended as the gold standard.

scholarly journals Inguinal hernia repair in preterm neonates: is there evidence that spinal or general anaesthesia is the better option regarding intraoperative and postoperative complications? A systematic review and meta-analysis

BMJ Open ◽  
2019 ◽  
Vol 9 (10) ◽  
pp. e028728 ◽  
Author(s):  
Katharina Dohms ◽  
Marc Hein ◽  
Rolf Rossaint ◽  
Mark Coburn ◽  
Christian Stoppe ◽  
...  
Keyword(s):  
Inguinal Hernia ◽  
Postoperative Complications ◽  
Hernia Repair ◽  
Hospital Stay ◽  
General Anaesthesia ◽  
Inguinal Hernia Repair ◽  
Outcome Measures ◽  
Meta Analysis ◽  
Controlled Trials ◽  
Duration Of Surgery

ObjectivesWhether spinal anaesthesia (SA) reduces intraoperative and postoperative complications compared with general anaesthesia (GA) was investigated.DesignThe meta-analysis was structured based on the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) statement. Databases (PubMed, MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials and Web of Science) were searched, and four randomised controlled trials (RCTs) and two retrospective cohort studies were included. A random-effects model with pooled risk ratios and mean differences with 95% CIs were used. Statistical heterogeneity was evaluated using the I2statistic. Quality assessment of the studies was performed by assessing the risk of bias according to the Cochrane and GRADE methodology.SettingPublications from January 1990 to November 2018 were included.Participants and interventionsOur study selection captured information from studies focusing on neonates born before the 37th gestational week who were scheduled for an inguinal hernia repair operation under either SA or GA.Primary and secondary outcome measuresThe primary outcome measures were apnoea, postoperative ventilation and method failure rates according to predefined eligibility criteria. The duration of surgery, desaturation events <80%, hospital stay duration and postoperative bradycardia were secondary outcomes.ResultsWe found significantly fewer events for the outcomes ‘any episode of apnoea’ and ‘mechanical ventilation postoperatively’ in the SA group. Bradycardias were significantly less common in the SA group. In total, 7.5% of the SA group were converted to GA. The duration of surgery was significantly shorter in the SA group. No significant differences were found in the outcome measures ‘postoperative oxygen supplementation’, ‘prolonged apnoea’, ‘postoperative oxygen desaturation <80%’ and ‘hospital stay’.ConclusionsWe consider SA a convenient alternative for hernia repair in preterm infants, providing more safety regarding postoperative apnoea. To the best of our knowledge, this is the first meta-analysis to include studies exclusively comparing SA versus GA. More high-quality RCTs are needed.Trial registration numberCRD42016048683

Follow-up after inguinal hernia repair. Questionnaire compared with physical examination: a prospective study in 299 patients

2003 ◽  
Vol 164 (7) ◽  
pp. 533-536 ◽  
Author(s):  
Patrick M. Vos ◽  
Maarten P. Simons ◽  
Jan S. K. Luitse ◽  
Dick van Geldere ◽  
Mark J. W. Koelemaij ◽  
...  
Keyword(s):  
Inguinal Hernia ◽  
Physical Examination ◽  
Hernia Repair ◽  
Prospective Study ◽  
Inguinal Hernia Repair ◽  
A Prospective Study

Comparative Study Between Caudal Block And Local Wound Infiltration In Inguinal Hernia Repair In Pediatric Patients

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Azza Mohamed Shafeek Abdel Mageed ◽  
Wael Reda Hussaein ◽  
Rania Hassan Abdel Hafiez ◽  
Tarek Atef Abdullah Hammouda
Keyword(s):  
Inguinal Hernia ◽  
Hernia Repair ◽  
Pain Score ◽  
Inguinal Hernia Repair ◽  
Postoperative Analgesia ◽  
Pediatric Patients ◽  
Caudal Block ◽  
Wound Infiltration ◽  
Unilateral Inguinal Hernia ◽  
Significant Difference

Abstract Background Postoperative analgesia can be provided by a multimodal approach includes opioids, nonsteroidal anti-inflammatory drugs, paracetamol infusion and regional anesthetic techniques such as local infiltration or nerve blocks. In contrast to opioids, local anesthetics can be administered safely and in recent guidelines regional anesthesia is accepted as the cornerstone of postoperative pain relief in the pediatric patients. Objective Compare the postoperative analgesic effectiveness of local wound infiltration of bupivacaine against bupivacaine administered caudally in pediatric patients undergoing unilateral inguinal hernia repair. Patients and methods This study was carried out in Ain Shams University hospitals on 40 pediatric patients of both sexes aged from 6 months to 7 years belonging to ASA I or II undergoing elective unilateral inguinal hernia repair. They were randomly allocated into two groups: group C receiving caudal block, group L receiving local wound infiltration. Hemodynamic changes, postoperative pain score using FLACC pain score, postoperative analgesia and complications were recorded. Results There was no significant difference between the two groups as regard demographic data or hemodynamic variables. Pain score shows no statically significant differences between two groups in the first hour. But statistically significant decrease in FLACC score after (1, 2 and 3 hours) in group C in comparison with group L.decreased significantly in group C after 1 hour postoperative. Duration of analgesia longer in group C with no significant difference in total amount of postoperative analgesia. There was significant increase in incidence in complications in group C than group L Conclusion Caudal block provides better and longer analgesia but requires experience and may lead to complications. In contrast, wound infiltration is simple without significant side effects. Therefore, local wound infiltration may be a preferred technique for producing postoperative analgesia in pediatric inguinal hernia repair.

scholarly journals Cynoacrylate surgical glue as an alternative to suturing for mesh fixation in lichtenstein hernia repair

2018 ◽  
Vol 5 (5) ◽  
pp. 1882
Author(s):  
Deepak Jaiswal ◽  
TRV Wilkinson ◽  
Murtaza Akhtar
Keyword(s):  
Inguinal Hernia ◽  
Hernia Repair ◽  
Inguinal Hernia Repair ◽  
Mesh Fixation ◽  
Tertiary Care ◽  
Operating Time ◽  
Recurrent Hernia ◽  
Care Hospital ◽  
Lichtenstein Hernia Repair ◽  
Average Pain

Background: Tension free repair using mesh in open hernia repair has become more popular in recent years. Chronic pain remains a frequent complication after Lichtenstein inguinal hernia repair. The use of sutures to fix the mesh has been implicated. Fixing the mesh using cynoacrylate glue could avoid this complication. The purpose of the present study is to study the incidence of pain and other complications following inguinal hernia repair performed by the Lichtenstein technique with mesh fixation by cyanoacrylate surgical glue.Methods: T This study was conducted at tertiary care hospital. Inclusion criteria were all patients coming to the hospital with inguinal or inguinoscrotal hernias diagnosed clinically. Exclusion criteria were all complicated inguinal hernia namely obstructed, strangulated, and large hernias with scrotal abdomen, recurrent hernia. Patient not fit for surgery or not consenting to join the study. The patients will be informed about the surgery and thereafter requested to sign an informed consent. Primary outcome was postoperative pain. Secondary endpoints were operating time, surgical site infection and recurrence rate.Results: Total number of 31 cases enrolled in the study of which twenty-two had unilateral and seven had bilateral inguinal hernias. Average pain score on POD 1, 3, 7 was 5.75; 4.53; 3.32 respectively. One patient developed seroma which was managed conservatively. No evidence of recurrence during study period.Conclusions: Cyanoacrylate surgical glue is a reliable method and can be used as an alternative for conventional Lichtenstein hernia repair.

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